Pathogenesis and Pharmacotherapy of Acute Respiratory Distress Syndrome Induced by Pandemic Viral Infections: A Narrative Review

TL;DR

This review explores how pandemic viruses cause ARDS and discusses current and emerging treatments for this severe lung condition.

Contribution

The paper provides a comprehensive analysis of viral-induced ARDS pathogenesis and pharmacotherapy, emphasizing the need for tailored therapeutic strategies.

Findings

Viral infections like SARS-CoV-2 are significant causes of ARDS, leading to severe lung injury and immune dysregulation.

Current treatments include supportive care and emerging therapies targeting lung injury mechanisms.

Virus-induced ARDS may require distinct management approaches compared to other ARDS causes.

Abstract

Acute respiratory distress syndrome (ARDS) is a severe, life-threatening condition characterized by acute hypoxemic respiratory failure, bilateral pulmonary infiltrates, and non-cardiogenic pulmonary edema caused by increased alveolar-capillary permeability. ARDS is highly heterogeneous, with diverse etiologies and clinical presentations that complicate diagnosis and management. Viral infections, including influenza A (H1N1 and H5N1) and coronaviruses such as SARS-CoV-2, are major contributors to ARDS and can trigger severe lung injury, hyperinflammation, and dysregulated immune responses. Ongoing viral evolution and periodic emergence of novel strains continue to pose a substantial threat to global public health. This narrative review analyzes pandemic-associated viral causes of ARDS, summarizes key mechanisms of pathogenesis, and evaluates current and emerging pharmacotherapeutic approaches. A comprehensive literature search was conducted using PubMed, supplemented by additional sources where appropriate. The review highlights that the increasing prominence of viral pneumonia as a cause of ARDS requires both established supportive care and tailored therapeutic strategies that target the underlying mechanisms of lung injury. Despite progress, virus-associated ARDS remains a major clinical challenge with high morbidity and mortality and may require management approaches distinct from those used for other ARDS etiologies.